What do the new COVID-19 variants mean for Uganda?

Viruses constantly change through mutation, and new variants of a virus are expected to occur over time. Sometimes new variants emerge and disappear. Other times, new variants emerge and persist.

Multiple variants of the virus that causes COVID-19 have been documented in the Uganda and globally during this pandemic.

These variants include:

U.K. (B.1.1.7)

This COVID-19 variant appears to spread more easily and might have an increased risk of death.

South Africa (B.1.351).

This variant appears to spread more easily. It also has a moderate impact on the effectiveness of monoclonal antibody medications and moderately reduces the effectiveness of antibodies generated by a previous COVID-19 infection or COVID-19 vaccine.

 

Japan/Brazil (P.1)

This variant has a moderate impact on the effectiveness of monoclonal antibody medications. It also reduces the effectiveness of antibodies generated by a previous COVID-19 infection or a COVID-19 vaccine.

 

U.S. (California) (B.1.427)

This variant appears to spread more easily. It also has a significant impact on the effectiveness of some treatments and moderately reduces the effectiveness of antibodies generated by a previous COVID-19 infection or COVID-19 vaccine.

 

U.S. (California) (B.1.429)

This variant appears to spread more easily. It also has a significant impact on the effectiveness of some treatments and moderately reduces the effectiveness of antibodies generated by a previous COVID-19 infection or COVID-19 vaccine.

The virus that causes COVID-19 is a type of coronavirus, a large family of viruses. Coronaviruses are named for the crown-like spikes on their surfaces. Scientists monitor changes in the virus, including changes to the spikes on the surface of the virus. These studies, including genetic analyses of the virus, are helping scientists understand how changes to the virus might affect how it spreads and what happens to people who are infected with it.

These have a mutation similar to the fast-spreading variant in the UK, South Africa among other countries.

“The virus that causes COVID-19 – evolve over time just like any other virus. When a virus replicates or makes copies of itself, it sometimes changes a little bit, which is normal for a virus. These changes are called “mutations”. A virus with one or more new mutations is referred to as a “variant” of the original virus.

This new mutation meant Covid-19 could suddenly latch onto an important molecule found scattered around the outside of human respiratory cells called Neuropilin 1. This molecule helps to transport material inside cells and deeper into tissues – the mutation was like handing Covid-19 the keys to a new door into our cells and meant the virus could replicate in greater numbers in the human airways.

The spike protein forms part of the coronavirus outer layer and is what the virus uses to make contact with human cells, bind to them, then enter and infect them.

The vaccines have been designed to create antibodies which target the spike protein of the virus specifically. The worry is that if a mutation changes the shape of the spike protein significantly then the antibodies may not be able to recognise and neutralise the virus effectively.

The COVID-19 vaccines that are currently in development or have been approved are expected to provide at least some protection against new virus variants because these vaccines elicit a broad immune response involving a range of antibodies and cells.

 

Are the vaccines effective against the new variants?

At the moment, most vaccines appear to be effective against the variants. But public health officials are deeply worried that future iterations of the virus may be more resistant to the immune response, requiring Americans to queue up for regular rounds of booster shots or even new vaccines

 

Are the vaccines safe for pregnant and breastfeeding women?

A study by Harvard University, published in the American Journal of Obstetrics and Gynaecology, examined responses to vaccines in 131 women (84 pregnant, 31 lactating and 16 non-pregnant). They were given the full two doses of either the Pfizer or Moderna COVID-19 vaccines and antibody levels were checked in maternal blood and breast milk before the study, at the time of the second dose and then again two to six weeks after the second dose.

In those women who were pregnant, baby umbilical cord blood was also tested after delivery for the presence of maternal antibodies triggered by the vaccine. The study also compared these antibody levels with a group of women who had previously been infected by COVID-19.

The results showed that women – whether they were pregnant, breastfeeding or neither – had similar levels of antibodies after the two vaccine doses.

Vaccine-generated antibodies were present in all umbilical cord blood and breast milk samples. The second dose increased specific antibodies, called immunoglobulin G (IgG). These form the basis of long-term protection against the virus; they are retained and reproduce rapidly when exposed to the real virus, neutralising it before it has a chance to take hold and cause a full-blown infection. Importantly, side effects from the vaccines were rare and equally reported in all three groups of women.

When vaccine-induced antibody levels were compared with those of women who had antibodies because of a previous infection of COVID-19, they were found to be higher. This means the vaccines are more likely to provide more robust and longer-lasting protection against coronavirus in the future compared with any protection gained through a previous infection.

Uganda’s status on variants

In an interview with Nile Post, Lt. Col. Dr. Henry Kyobe Bosa the Ministry of Health COVID-19 Incident Commander says that Uganda has registered a second form variant B.1.351 a month after the first variant A.23.1. was discovered last month.

Dr. Kyobe notes that the ministry is in a dilemma over the discovery of these variants amidst laxity by the public to observe SOPs.

“We are likely to see a rise in the numbers of COVD 19 related cases and deaths because we don’t know the new variants will behave. One of the variants has been reported in South Africa to be attacking young people aged 5- 19. And yet, according to our vaccination target groups, these are not yet catered for.” he said.

Current measures to reduce transmission – including frequent hand washing, wearing a mask, physical distancing, good ventilation and avoiding crowded places or closed settings – continue to work against new variants by reducing the amount of viral transmission and therefore also reducing opportunities for the virus to mutate.

Sources: WHO, Harvard University, Mayo Clinic and CDC